Claudication

First up, I suggest you change your doctor ASAP.

Hello Joe?
I was given this diagnosis of Claudication and Neurathapy
I’m 74 and have had type 1 since 1996.
I have had similar to what your experiencing.?
However I urge you to have a full spinal MRI
I had several nerves compromised in my spine
all of which can cause a lot of the symptoms you mention
A series of spinal injections at different levels S1 L5
and T6789 cervical helped me enormously.?
Cost to the NHS IS ONE OF THE REASONS THIS IS NOT SUGGESTED TO YOU..
This has helped me worth considering and if so I hope it works for you.
Regards Jim.

Ask for a Doppler test and to see a vascular surgeon (if needed).

I also have severe claudication (abi < 0.09, which is record low). What I do against it is cycling as much as I can (on an electric bike, which you want/need also) to built collaterals, improve circulation and keep my glucose low (according to many studies and one of my doctors glucose spikes cause atherosclerosis, there was a thread about it on this forum).

Also walk as much as you can, try to find "exercise for intermittent claudication" part 1 and 2 by James Skinner from 1967 and follow his original guidelines (not what they made of it later).

If you smoke you should definitely stop that.

Hi Kate
Sympathies, that sounds awful for you.
I agree with all three previous responders.
I have T2 and my vascular system is compromised (if that's indeed what you have) but whatever the cause of your troubles I suggest good, low carb diet, no smoking and keep moving as much as you can, I was told to try and push through the pain. Research a little perhaps on stuff like glucose and inflammation. Again I'm not saying that is the actual reason you're suffering, but it leads you to other things, like different diets for example.
BUT whatever you do, first thing is to get a second opinion! You need somebody on your side. Any doctor who leaves you in the lurch feeling frightened like that needs a kick up....... well you know.
Best of luck.

Jo_the_boat said:

I was told to try and push through the pain.

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That is what the guidelines say, based on this study:
Exercise Rehabilitation Programs for the Treatment of Claudication Pain
“The greatest improvement in pain distances occurred with the following exercise program: duration greater than 30 minutes per session, frequency of at least three sessions per week, walking used as the mode of exercise, use of near-maximal pain during training as claudication pain end point, and program length of greater than 6 months”.

If you look at table 2 you can see the Skinner study from ‘67 (part 2), one of the only 6 “near maximal” pain studies had a huge impact on the result and the conclusions of the first study. But the subjects didn’t walk to maximal pain at all, but to 75% of a self imposed maximum, which had a very possitive effect:

“In every case the greatest reduction in AP (Ankle Pressure) occurred after the initial maximal walk. With repetition of exercise each subject displayed a progressive increase in either the AP level taken 2 minutes postexercise or the rate of recovery of AP to the pre-exercise level.” The term “walk through experience” which they use in the first study comes from this study also.

This in turn was based on a previous succesfull therapy:

“Schliissel had his patients walk on a level grade until pain first developed and used two thirds of that time as the training load. He emphasized that patients should not increase the tempo of walking above 60 steps per minute or reach the stage of claudication. The patients would walk at two-thirds CPT, stand for 1 to 3 minutes, and repeat for 10 to 20 minutes; this was done three times daily. He gave little data but reported significant increases in CPT and MWT in 20 patients with intermittent claudication.”

The study Supervised walking therapy in patients with intermittent claudication comments on the first study “Although the present systematic review used results from RCTs only and therefore is less prone to confounding due to selection bias, our results do not support these prior recommendations” which is a nice way to put it. They found “pain free” exercise gained 28% average walking distance change more than “max pain” (257m vs 177m).

Especially for diabetics it is better to walk and exercise pain- and therefore stress free.

Liftupjoe said:

Thank you for the reply, your information was very interesting, I will definitely look into it, I am moving to a different area next week to live and will definitely discuss this with my new doctor.
Thank you
Kate

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Good luck hope you improve health wise.